0000899243-20-011310.txt : 20200424 0000899243-20-011310.hdr.sgml : 20200424 20200424173912 ACCESSION NUMBER: 0000899243-20-011310 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200424 FILED AS OF DATE: 20200424 DATE AS OF CHANGE: 20200424 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HENDRICKSON CAREY P CENTRAL INDEX KEY: 0001482760 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13445 FILM NUMBER: 20816330 MAIL ADDRESS: STREET 1: 400 S. RECORD STREET CITY: DALLAS STATE: TX ZIP: 75202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CAPITAL SENIOR LIVING CORP CENTRAL INDEX KEY: 0001043000 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 752678809 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14160 DALLAS PARKWAY STREET 2: SUITE 300 CITY: DALLAS STATE: TX ZIP: 75254 BUSINESS PHONE: 9727705600 MAIL ADDRESS: STREET 1: 14160 DALLAS PARKWAY STREET 2: SUITE 300 CITY: DALLAS STATE: TX ZIP: 75254 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-04-24 0 0001043000 CAPITAL SENIOR LIVING CORP CSU 0001482760 HENDRICKSON CAREY P 14160 DALLAS PARKWAY SUITE 300 DALLAS TX 75254 0 1 0 0 Executive Vice President & CFO Common Stock 2020-04-24 4 D 0 38362 0.00 D 322164 D Represents shares of performance-based restricted stock that were previously reported as beneficially owned by the reporting person as of March 28, 2017, but were subsequently forfeited due to the Company not achieving the performance target with respect to such shares. /s/ Carey P. Hendrickson 2020-04-24